Patient with B-CLL with a History of Unrelated Hematopoietic Cells Donation – Retrospective Analysis of CLL Development and Implication for the Recipient
Authors:
P. Jindra 1; L. Žejšková 2; S. Peková 2; J. Navrátilová 1; M. Schutzova 1; S. Vokurka 1; V. Koza 1
Authors place of work:
Hematologicko-onkologické oddělení, FN Plzeň
1; Laboratoř molekulární diagnostiky, Praha
2
Published in the journal:
Klin Onkol 2012; 25(3): 212-215
Category:
Case Reports
Summary
Background:
Donor cell leukemia (DCL) is a relatively rare but well documented complication of hematopoietic stem cell transplantation. So far, publications described only DCL arising de novo in the recipient.
Observation:
In this study, we describe a case of chronic lymphocytic leukemia (B-CLL) developing in a volunteer unrelated donor from the Czech National Marrow Donors Registry (CNMDR) several years after donation. From archival DNA sample, we have retrospectively found that subclinical CLL clone was already present at the time of donation but early death of recipient prevented eventual development of DCL. This case documents well the long period between detection of B-CLL clone and full development of clinical-laboratory symptomatology. The medical and ethical questions posed by an isolated case of detection of hematological malignancy present either only in the donor or only in the recipient are discussed.
Conclusion:
The case demonstrates the increasing risk of development of various forms of DCL and thus highlights the need for long-term monitoring of stem cell donor, not only in terms of health of donor but also in terms of potential risks for the recipient.
Key words:
donor cell leukemia – chronic lymphocytic leukemia – grafts – donors
The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.
The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.
Submitted:
13. 9. 2011
Accepted:
7. 11. 2011
Zdroje
1. Fialkow PJ, Thomas ED, Bryant JI et al. Leukaemic transformation of engrafted human marrow cells in vivo. Lancet 1971; 1(7693): 251–255.
2. Hertenstein B, Hambach L, Bacigalupo A et al. Development of leukemia in donor cells after allogeneic stem cell transplantation – a survey of the European Group for Blood and Marrow Transplantation (EBMT). Haematologica 2005; 90(7): 969–975.
3. Flynn CM, Kaufman DS. Donor cell leukemia: insight into cancer stem cells and the stem cell niche. Blood 2007; 109(7): 2688–2692.
4. Igarashi N, Chou T, Hirose T et al. Donor cell-derived acute lymphocytic leukemia after allogeneic stem cell transplantation for multiple myeloma. Int J Hematol 2009; 90(3): 378–382.
5. Nařízení vlády, kterým se provádí zákon č. 285/2002 Sb., o darování, odběrech a transplantacích tkání a orgánů a o změně některých zákonů (transplantační zákon), č. 436/2002 Sb. a Vyhláška Ministerstva zdravotnictví, kterou se stanoví bližší podmínky posuzování zdravotní způsobilosti a rozsah vyšetření žijícího nebo zemřelého dárce tkání nebo orgánů pro účely transplantací (vyhláška o zdravotní způsobilosti dárce tkání a orgánů pro účely transplantací), č. 437/2002 Sb.
6. Worldmarrow.org [online], The World Marrow Donor Association (WMDA). Last update: 2011 June 06, cited 2011 June 23. Available from: http://www.worldmarrow.org/.
7. Jacie.org [online], The Joint Accreditation Committee--ISCT (Europe) & EBMT (JACIE-EBMT). Last update: 2011 June 22, cited 2011 June 25. Available from: http://www.jacie.org/.
8. Peková S, Bezdíčková L, Smolej L et al. Quantitation of minimal residual disease in patients with chronic lymphocytic leukemia using locked nucleic acid-modified, fluorescently labeled hybridization probes and real-time PCR technology. Mol Diagn Ther 2007; 11(5): 325–335.
9. Boyd CN, Ramberg RC, Thomas ED. The incidence of recurrence of leukemia in donor cells after allogeneic bone marrow transplantation. Leuk Res 1982; 6(6): 833–837.
10. Nagler A, Korenstein-Ilan A, Amiel A et al. Granulocyte colony-stimulating factor generates epigenetic and genetic alterations in lymphocytes of normal volunteer donors of stem cells. Exp Hematol 2004; 32(1): 122–130.
11. Bennett CL, Evens AM, Andritsos LA et al. Haematological malignancies developing in previously healthy individuals who received haematopoietic growth factors: report from the Research on Adverse Drug Events and Reports (RADAR) project. Br J Haematol 2006; 135(5): 642–650.
12. Halter J, Kodera Y, Ispizua AU et al. Severe events in donors after allogeneic hematopoietic stem cell donation. Haematologica 2009; 94(1): 94–101.
13. Confer DL, Miller JP. Long-term safety of filgrastim (rhG-CSF) administration. Br J Haematol 2007; 137(1): 77–78.
14. Sala-Torra O, Hanna C, Loken MR et al. Evidence of donor-derived hematologic malignancies after hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2006; 12(5): 511–517.
15. Perz JB, Ritgen M, Moos M et al. Occurence of donor--derived CLL 8 years after sibling donor SCT for CML. Bone Marrow Transplant 2008; 42(10): 687–688.
16. Flandrin-Gresta P, Callanan M, Nadal N et al. Transmission of leukemic donor cells by allogeneic stem cell transplantation in a context of familial CLL: should we screen donors for MBL? Blood 2010; 116(23): 5077–5078.
17. Kostnidren.cz [online], Český Národní Registr Dárců Dřeně (ČNRDD). Last update: 2011 August 31, cited 2011 September 3. Dostupné z: http://www.kostnidren.cz/registr.
18. Vokurka S, Koza V, Jungová A et al. Výskyt malignit a dispenzarizace dárců krvetvorných buněk – výsledky sledování Hematologicko-onkologického oddělení FN Plzeň a Českého národního registru dárců dřeně. Klin Onkol 2012; 25(1): 42–46.
Štítky
Paediatric clinical oncology Surgery Clinical oncologyČlánok vyšiel v časopise
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